Gil-Ugidos Antonio, Rodríguez-Salgado Dolores, Pidal-Miranda Marina, Samartin-Veiga Noelia, Fernández-Prieto Montse, Carrillo-de-la-Peña Maria Teresa
Brain and Pain (BaP) Laboratory, Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain.
Genetics Group, GC05, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain.
Front Psychol. 2021 Oct 21;12:747533. doi: 10.3389/fpsyg.2021.747533. eCollection 2021.
Working memory (WM) is a critical process for cognitive functioning in which fibromyalgia (FM) patients could show cognitive disturbances. Dyscognition in FM has been explained by interference from pain processing, which shares the neural substrates involved in cognition and may capture neural resources required to perform cognitive tasks. However, there is not yet data about how pain is related to WM performance, neither the role that other clinical variables could have. The objectives of this study were (1) to clarify the WM status of patients with FM and its relationship with nociception, and (2) to determine the clinical variables associated to FM that best predict WM performance. To this end, 132 women with FM undertook a neuropsychological assessment of WM functioning (Digit span, Spatial span, ACT tests and a 2-Back task) and a complete clinical assessment (FSQ, FIQ-R, BDI-1A, HADS, PSQI, MFE-30 questionnaires), including determination of pain thresholds and tolerance by pressure algometry. Patients with FM seem to preserve their WM span and ability to maintain and manipulate information online for both visuospatial and verbal domains. However, up to one-third of patients showed impairment in tasks requiring more short-term memory load, divided attention, and information processing ability (measured by the ACT task). Cognitive performance was spuriously related to the level of pain experienced, finding only that pain measures are related to the ACT task. The results of the linear regression analyses suggest that sleep problems and fatigue were the variables that best predicted WM performance in FM patients. Future research should take these variables into account when evaluating dyscognition in FM and should include dynamic measures of pain modulation.
工作记忆（WM）是认知功能的关键过程，纤维肌痛（FM）患者在这一过程中可能会出现认知障碍。FM中的认知功能障碍已被解释为疼痛处理的干扰，疼痛处理与认知过程共享神经基质，并且可能占用执行认知任务所需的神经资源。然而，目前尚无关于疼痛与工作记忆表现之间关系的数据，也不清楚其他临床变量可能发挥的作用。本研究的目的是：（1）阐明FM患者的工作记忆状态及其与伤害感受的关系；（2）确定与FM相关的、能最佳预测工作记忆表现的临床变量。为此，132名FM女性患者接受了工作记忆功能的神经心理学评估（数字广度、空间广度、ACT测试和2-back任务）以及全面的临床评估（FSQ、FIQ-R、BDI-1A、HADS、PSQI、MFE-30问卷），包括通过压力测痛法测定疼痛阈值和耐受性。FM患者似乎在视觉空间和语言领域都保留了他们的工作记忆广度以及在线维持和处理信息的能力。然而，多达三分之一的患者在需要更多短期记忆负荷、分散注意力和信息处理能力的任务（通过ACT任务测量）中表现受损。认知表现与所经历的疼痛程度存在虚假关联，仅发现疼痛测量与ACT任务相关。线性回归分析结果表明，睡眠问题和疲劳是最能预测FM患者工作记忆表现的变量。未来的研究在评估FM中的认知功能障碍时应考虑这些变量，并应纳入疼痛调节的动态测量。
